The analysis of the cause of repeated implantation failures is currently at the stage of accumulation of scientific knowledge. Immunomodulation of the endometrium after intrauterine insemination with activated autologous peripheral blood mononuclear cells may be a promising therapeutic solution.

OBJECTIVE OF THE STUDY

To determine the local cytokine profile of the endometrium in patients with multiple unsuccessful attempts at assisted reproductive technologies (ART) and the effectiveness of its correction with a lyophilisate solution of peripheral blood mononuclear cell secretome by intrauterine perfusion.

MATERIAL AND METHODS

The study included 55 patients aged 29 to 47 years with a history of infertility for more than 5 years and multiple ART failures. The patients were divided into 2 groups. The main group consisted of women who became pregnant, the comparison group consisted of women who did not become pregnant as a result of treatment. After treatment, 14 patients underwent repeated analysis of the local cytokine profile of the endometrium. The study of the endometrial microbiota and the determination of genes of markers of the local immune response were carried out using molecular biological tests.

RESULTS

When analyzing the ratios of innate immunity gene expression, statistically significant differences were found between the IL-18 indicators and the IL-10/IL-18 profile. The IL-18 level after treatment became significantly higher compared to the indicator before treatment, which was 3.8 [3.47; 4.07] and 3.3 [2.747; 3.5], respectively, p< 0.05. The IL-10/IL-18 ratio before treatment was 26.45 [21.64; 160.54], which was higher compared to the indicator after treatment — 16.7 [10.45; 50.77], p< 0.05.

CONCLUSIONS

After complex therapy with lyophilisate of peripheral blood mononuclear cell secretome (Superlymph), improvement of immunological parameters of the endometrium was achieved, increasing the probability of successful implantation. Intrauterine administration of peripheral blood mononuclear cell secretome has potentially shown itself as a good way to modulate endometrial receptivity.